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 21 February 2018

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News

Barrett's esophagus increases the risk of esophageal carcinomas

The unexpected fall in adenocarcinoma of the esophagus amongst elderly patients was most probably caused by a declining prevalence rate of Barrett's esophagus, reports April's issue of The American Journal of Gastroenterology.

News image

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Adenocarcinoma limited to the esophagus arises in Barrett's esophagus.

The incidence of adenocarcinoma is therefore restricted to this Barrett's esophagus subpopulation, whose size is unknown and which is for 95% unidentified.

Dr van Blankenstein and colleagues studied the age and gender specific incidence rates of adenocarcinoma of the esophagus, limited to the Barrett's esophagus subpopulation, within a defined geographical area.

The research team used a comparison group of those with squamous cell carcinoma of the esophagus, which can affect the entire population.

An expert panel classified 87% of all cases of adenocarcinoma of the esophagus reported to the Danish Cancer Registry over a 6 year period as adenocarcinoma of the esophagus.

Age-specific incidence rates of adenocarcinoma of the esophagus fell at 85 years and above
The American Journal of Gastroenterology

The team then calculated the age and gender specific incidence rates for adenocarcinoma of the esophagus and adenocarcinoma of the cardia.

The researchers noted that the age-specific incidence rates of adenocarcinoma of esophagus for males rose between 30 to 84 years, falling at 85 years and above.

The investigators reported that for females the age specific incidence rates of adenocarcinoma of the esophagus rose between 30 to 84 years, falling at 85 years and above.

The researcher’s results yielded a gender ratio of 6:1 with adenocarcinoma of the cardia demonstrating a similar pattern and a gender ratio of 4:1.

However, the incidence rates of squamous cell carcinoma continued rising after the age of 80 yr, with a gender ratio of 2:1.

Dr van Blankenstein concludes, “The continuing rise in the squamous cell carcinoma incidence rates in the elderly demonstrates that the unexpected fall in the incidence rates of adenocarcinoma of the esophagus over the age of 80 years did not result from underdiagnosis.”

“This was most probably caused by a declining prevalence rate of Barrett's esophagus, restricting the elderly Barrett's esophagus subpopulation at risk of developing adenocarcinoma of the esophagus.”

Am J Gastroenterol 2005: 100(4): 766
29 March 2005

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